Special Claims Field Investigator
Ohio, IL · Remote
$67K - $79K/yr
Gathers and analyzes data to identify inconsistencies, potential fraud, and the overall legitimacy ... Excludes seasonal employees and interns.
Ohio, IL · Remote
$67K - $79K/yr
Gathers and analyzes data to identify inconsistencies, potential fraud, and the overall legitimacy ... Excludes seasonal employees and interns.
Ohio, IL · Remote
$67K - $79K/yr
Gathers and analyzes data to identify inconsistencies, potential fraud, and the overall legitimacy ... Excludes seasonal employees and interns.
$70K - $80K/yr
Investigates all suspect fraud referrals. * Secures necessary information (i.e., reports, policies ... Excludes seasonal employees and interns.
$70K - $80K/yr
Investigates all suspect fraud referrals. * Secures necessary information (i.e., reports, policies ... Excludes seasonal employees and interns.
Chesterfield, MO · On-site +1
Internship Location: Headquarters Description Healthcare Fraud Shield is seeking a part-time Fraud ... Understanding of pharmacy and medical claims data analysis and quality monitoring * Maintain alert ...
Chesterfield, MO · On-site +1
Internship Location: Headquarters Description Healthcare Fraud Shield is seeking a part-time Fraud ... Understanding of pharmacy and medical claims data analysis and quality monitoring * Maintain alert ...
$65K - $84K/yr
... on risk, fraud, and field support management. This role is a great opportunity for someone who ... An internship of other prior work experience in a corporate office is preferred. * Intermediate ...
New
$65K - $84K/yr
... on risk, fraud, and field support management. This role is a great opportunity for someone who ... An internship of other prior work experience in a corporate office is preferred. * Intermediate ...
New
Order troubleshooting: Assist ops team members with resolving order issues caused by missing/inadequate information, fulfillment issues, complaints, fraud claims, backend system problems, etc.
Order troubleshooting: Assist ops team members with resolving order issues caused by missing/inadequate information, fulfillment issues, complaints, fraud claims, backend system problems, etc.
Order troubleshooting: Assist ops team members with resolving order issues caused by missing/inadequate information, fulfillment issues, complaints, fraud claims, backend system problems, etc.
Order troubleshooting: Assist ops team members with resolving order issues caused by missing/inadequate information, fulfillment issues, complaints, fraud claims, backend system problems, etc.
Order troubleshooting: Assist ops team members with resolving order issues caused by missing/inadequate information, fulfillment issues, complaints, fraud claims, backend system problems, etc.
Order troubleshooting: Assist ops team members with resolving order issues caused by missing/inadequate information, fulfillment issues, complaints, fraud claims, backend system problems, etc.
Order troubleshooting: Assist ops team members with resolving order issues caused by missing/inadequate information, fulfillment issues, complaints, fraud claims, backend system problems, etc.
Order troubleshooting: Assist ops team members with resolving order issues caused by missing/inadequate information, fulfillment issues, complaints, fraud claims, backend system problems, etc.
Rancho Cordova, CA · On-site +1
$52K - $86K/yr
... evaluating claims for potential fraud. * Participate in Telephonic and/or onsite File Reviews ... Previous internship or work experience in insurance, finance, or customer service. * Strong ...
Rancho Cordova, CA · On-site +1
$52K - $86K/yr
... evaluating claims for potential fraud. * Participate in Telephonic and/or onsite File Reviews ... Previous internship or work experience in insurance, finance, or customer service. * Strong ...
Walnut Creek, CA · On-site +1
$52K - $86K/yr
... evaluating claims for potential fraud. * Participate in Telephonic and/or onsite File Reviews ... Previous internship or work experience in insurance, finance, or customer service. * Strong ...
Walnut Creek, CA · On-site +1
$52K - $86K/yr
... evaluating claims for potential fraud. * Participate in Telephonic and/or onsite File Reviews ... Previous internship or work experience in insurance, finance, or customer service. * Strong ...
Rancho Cordova, CA · On-site +1
$52K - $86K/yr
... evaluating claims for potential fraud. * Participate in Telephonic and/or onsite File Reviews ... Previous internship or work experience in insurance, finance, or customer service. * Strong ...
Rancho Cordova, CA · On-site +1
$52K - $86K/yr
... evaluating claims for potential fraud. * Participate in Telephonic and/or onsite File Reviews ... Previous internship or work experience in insurance, finance, or customer service. * Strong ...
Rancho Cordova, CA · On-site
$52K - $86K/yr
... evaluating claims for potential fraud. * Participate in Telephonic and/or onsite File Reviews ... Previous internship or work experience in insurance, finance, or customer service. * Strong ...
Rancho Cordova, CA · On-site
$52K - $86K/yr
... evaluating claims for potential fraud. * Participate in Telephonic and/or onsite File Reviews ... Previous internship or work experience in insurance, finance, or customer service. * Strong ...
Pittsburgh, PA · On-site +1
$52K - $86K/yr
... investigate claims such as Subrogation, Risk Control, nurse consultants, and fire or fraud ... Previous internship or work experience in insurance, legal, medical, customer service, or finance.
Pittsburgh, PA · On-site +1
$52K - $86K/yr
... investigate claims such as Subrogation, Risk Control, nurse consultants, and fire or fraud ... Previous internship or work experience in insurance, legal, medical, customer service, or finance.
Wyomissing, PA · On-site +1
$52K - $86K/yr
... investigate claims such as Subrogation, Risk Control, nurse consultants, and fire or fraud ... Previous internship or work experience in insurance, legal, medical, customer service, or finance.
Wyomissing, PA · On-site +1
$52K - $86K/yr
... investigate claims such as Subrogation, Risk Control, nurse consultants, and fire or fraud ... Previous internship or work experience in insurance, legal, medical, customer service, or finance.
Wyomissing, PA · On-site
$52K - $86K/yr
... investigate claims such as Subrogation, Risk Control, nurse consultants, and fire or fraud ... Previous internship or work experience in insurance, legal, medical, customer service, or finance.
Wyomissing, PA · On-site
$52K - $86K/yr
... investigate claims such as Subrogation, Risk Control, nurse consultants, and fire or fraud ... Previous internship or work experience in insurance, legal, medical, customer service, or finance.
Hunt Valley, MD · On-site +1
$52K - $86K/yr
... investigate claims such as Subrogation, Risk Control, nurse consultants, and fire or fraud ... Previous internship or work experience in insurance, legal, medical, customer service, or finance.
Hunt Valley, MD · On-site +1
$52K - $86K/yr
... investigate claims such as Subrogation, Risk Control, nurse consultants, and fire or fraud ... Previous internship or work experience in insurance, legal, medical, customer service, or finance.
Wyomissing, PA · On-site +1
$52K - $86K/yr
... investigate claims such as Subrogation, Risk Control, nurse consultants, and fire or fraud ... Previous internship or work experience in insurance, legal, medical, customer service, or finance.
Wyomissing, PA · On-site +1
$52K - $86K/yr
... investigate claims such as Subrogation, Risk Control, nurse consultants, and fire or fraud ... Previous internship or work experience in insurance, legal, medical, customer service, or finance.
$70K - $88K/yr
You'll be an active contributor on a team delivering forensic accounting, fraud investigation ... Lead, mentor, and coach interns and staff members in the Forensic Accounting group Basic ...
New
$70K - $88K/yr
You'll be an active contributor on a team delivering forensic accounting, fraud investigation ... Lead, mentor, and coach interns and staff members in the Forensic Accounting group Basic ...
New
Boston, MA · On-site
$80K - $101K/yr
You'll be an active contributor on a team delivering forensic accounting, fraud investigation ... Lead, mentor, and coach interns and staff members in the Forensic Accounting group Basic ...
New
Boston, MA · On-site
$80K - $101K/yr
You'll be an active contributor on a team delivering forensic accounting, fraud investigation ... Lead, mentor, and coach interns and staff members in the Forensic Accounting group Basic ...
New
$78K - $99K/yr
You'll be an active contributor on a team delivering forensic accounting, fraud investigation ... Lead, mentor, and coach interns and staff members in the Forensic Accounting group Basic ...
New
$78K - $99K/yr
You'll be an active contributor on a team delivering forensic accounting, fraud investigation ... Lead, mentor, and coach interns and staff members in the Forensic Accounting group Basic ...
New
$10.10 - $11.41
2% of jobs
$11.41 - $12.72
1% of jobs
$12.72 - $14.03
14% of jobs
$14.69 is the 25th percentile. Wages below this are outliers.
$14.03 - $15.34
16% of jobs
The median wage is $16.39 / hr.
$15.34 - $16.65
21% of jobs
$16.65 - $17.96
18% of jobs
$18.22 is the 75th percentile. Wages above this are outliers.
$17.96 - $19.27
14% of jobs
$19.27 - $20.59
5% of jobs
$20.59 - $21.90
2% of jobs
$21.90 - $23.21
2% of jobs
$23.21 - $24.52
4% of jobs
$10
$17
$24
$67K - $79K/yr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 15 days ago
8.8
Based on 27 frontline employees who took The Breakroom Quiz
53rd of 261 rated insurance
Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow.
At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.
Great American's Special Investigation Unit (SIU) stands to prevent, detect and investigate instances of potential insurance claims fraud, collaborating with business units in the proper handling and required reporting of fraudulent claims while exhibiting high professional standards of conduct.
Our SIU team is looking for a Special Claims Investigator to join their team. This individual must have the availability for up to 30% business travel, including overnight, both within their state of residence and to out of state locations. The position is fully remote. Travel is primarily by plane.
Essential Job Functions and Responsibilities
Detects and prevents fraudulent claims through meticulous investigation and analysis.
Gathers and analyzes data to identify inconsistencies, potential fraud, and the overall legitimacy of claims.
Prepares comprehensive reports summarizing investigation findings and recommends claim approval or denial.
Ensures claims are settled accurately and fairly, minimizing fraudulent activities and protecting the company's financial interests.
Contributes to the continuous improvement of investigation processes and techniques, enhancing overall efficiency and effectiveness.
Performs other duties as assigned.
Job Requirements
Bachelor's Degree in Criminal Justice, Risk Management and Insurance, Business Administration, or a related field or equivalent experience.
Generally, 3 to 6 years of related experience, including Criminal Investigation or Fraud Detection experience. Professional designation (i.e., Certified Fraud Examiner, Private Investigator license, etc.) from a recognized National Investigation Organization or State Agency preferred.
Ability for overnight travel.
This job is non-exempt in California and Washington
Business Unit:
Corporate Claims
Salary Range:
Benefits:
We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits.
Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at http://www.gaig.com/careers.
*Excludes seasonal employees and interns.
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Insurance services
5,001 - 10,000 Employees
Cincinnati, OH, US
1872